What are health professionals’ perceptions of conducting routine growth assessments and lifestyle interventions? A qualitative study involving allied health professionals, nurses and doctors in rural and regional New South Wales
Emma Schwartzkoff A B * , Tracy Burrows B , Andrew Bailey C , Eloise Sneddon A and Kerith Duncanson D EA Health Promotion, Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia.
B School of Health Sciences (Nutrition and Dietetics), University of Newcastle, Callaghan, NSW 2308, Australia.
C Research and Knowledge Translation, Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia.
D Heath Education and Training Institute (NSW Health), St Leonards, NSW 2067, Australia.
E School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia.
Australian Journal of Primary Health - https://doi.org/10.1071/PY22251
Submitted: 3 November 2022 Accepted: 10 May 2023 Published online: 29 June 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: Allied health professionals, nurses and doctors within the New South Wales (NSW) public health system provide trusted health information to a large proportion of families across the state. This means they are well positioned to opportunistically assess and discuss child weight status with families. Prior to 2016, weight status was not routinely addressed in most NSW public health settings, however recent policy changes promote quarterly growth assessments for all children aged under 16 years who attend these facilities. The Ministry of Health recommend health professionals use the 5 As framework, a consultation approach to encourage behaviour change, to identify and manage children with overweight or obesity. This study aimed to explore allied health professionals’, nurses’ and doctors’ perceptions of conducting routine growth assessments and providing lifestyle support to families in a local health district in rural and regional NSW, Australia.
Methods: This descriptive, qualitative study involved online focus groups and semi-structured interviews with health professionals. Audio recordings were transcribed and coded for thematic analysis, with rounds of data consolidation between research team members.
Results: Allied health professionals, nurses and doctors who work in a variety of settings within a local health district of NSW participated in one of four focus groups (n = 18 participants) or semi-structured interviews (n = 4). The predominant themes related to: (1) health professionals’ professional identity and their perceived scope of practice; (2) interpersonal qualities of health professionals; (3) the service delivery ecosystem in which health professionals worked. Diversity in attitudes and beliefs about routine growth assessments were not necessarily specific to discipline or setting.
Conclusions: Allied health professionals, nurses and doctors recognise the complexities involved in conducting routine growth assessments and providing lifestyle support to families. The 5 As framework used in NSW public health facilities to encourage behaviour change may not allow clinicians to address these complexities in a patient centred way. The findings of this research will be used to inform future strategies aimed at embedding preventive health discussions into routine clinical practice, and to support health professionals to identify and manage children with overweight or obesity.
Keywords: BMI-for-age, body weights and measures, health occupations, health professional perceptions, lifestyle intervention, obesity screening, paediatric overweight and obesity, preventive healthcare.
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